Q: Professor, a patient came in for chemotherapy again, but he was having trouble finding blood vessels in the back of his hands, forearms, feet and calves. We have just tried many times without success, and asked the head nurse to finally find a vessel that seemed usable, but a few hours later, the patient said it hurt a lot, and we found that the back of his hand and forearm were swollen, so we had to pull it out again! What should we do? A: Don’t worry, let’s implant an infusion port for him! Q: After implanting an infusion port, won’t our nurses have to work hard to find a blood vessel? A: That’s right! The so-called infusion port, which can also be called an intravascular catheter cartridge system, is a “transfer station” that can be implanted completely under the patient’s skin, allowing for easy delivery of drugs through the skin into the blood vessels. It is called an infusion port because its function is similar to that of a port, and it is primarily used to replace the previous role of puncturing a vein for infusion. With the implantation of infusion port, it can provide convenient and economic, safe and reliable intravenous access for patients who need long-term repeated infusion treatment, which greatly reduces the risk and pain of repeated venipuncture for patients. At the same time, the infusion port also greatly reduces the workload of nursing staff, so nurses no longer have to work hard to find the blood vessels, and it is even easier to do infusion treatment than to do an intramuscular injection, amazing, right? Q: How is the infusion port implanted under the skin? Where is it usually placed? A: Of course, we have to ask the patient and the family to sign the consent first, and then send it to the interventional catheterization laboratory for the physician to do a small procedure. How is it done? It is usually done under local anesthesia, and general anesthesia can be used for uncooperative patients. After strict sterilization and anesthesia, the subclavian vein is first punctured directly through the skin, and then the indwelling catheter is delivered into the superior vena cava using a guidewire and other auxiliary devices, the end of which should ideally be located in the lower part of the superior vena cava adjacent to the right atrium; after the catheter is placed, local anesthesia is applied to the subclavian fossa, a skin incision of about 2.5 cm is made, and the subcutaneous tissue is bluntly separated to form a subcutaneous pouch that is just large enough to Then, the catheter that has been placed in the blood vessel is connected to the infusion port through the subcutaneous tunnel at the vascular puncture site; finally, the infusion port is completely implanted into the subcutaneous bag through the skin incision, and the operation is completed by suturing the skin incision. The infusion port is usually placed in the lateral right subclavian fossa because it has little impact on the patient’s life, is convenient for care, and has the most direct route from the right subclavian vein to the superior vena cava. Of course, if the patient has special circumstances, other positions such as the left lateral subclavian or the more depressed position of the anterior medial thigh can be chosen. Q: How do you ensure that the catheter is well positioned in the infusion port? A: This can be ensured by performing this operation in the interventional catheterization room, as interventionalists are “intubation experts”! Generally, they can do it quickly and accurately. Since there is a DSA machine monitoring, a film can be taken immediately after implantation, and the position is clear at a glance, and if necessary, a few milliliters of contrast can be injected to confirm the position, which is very good evidence. If it is confirmed that the position is not good, it can be adjusted immediately, which is very convenient and quick. Q: Besides infusion, what are the other uses of the infusion port? A: The infusion port can be kept under the skin for a long time, not only for infusion of various daily drug fluids, but for chemotherapy patients, it can significantly reduce the damage to the peripheral veins and minimize or even eliminate the pain and other symptoms caused by the irritating drug solution. The superior vena cava is quickly diluted and less prone to damage due to its coarseness, and painful symptoms do not occur during infusion. Through the infusion port, parenteral nutrition support treatment and infusion of blood products can also be performed; in addition, when there is a need to draw blood for laboratory tests and other situations, blood samples can also be collected through the infusion port. Q: Is there anything I need to pay attention to after implanting the infusion port? A: Because the infusion port is completely protected by the skin, it is not easily detected by outsiders and is not easily infected, making it much easier to care for than a PICC (central venous catheter). Patients’ daily activities, showers, etc. are not affected and they can participate in sports such as swimming. However, care should still be taken to avoid pressure, impact and friction on the skin at the site of the infusion port cartridge implantation, and excessive traction on the ipsilateral limb. When puncturing the infusion port, non-invasive butterfly needles should be used as much as possible and aseptic operation should be guaranteed, while the injection site should be closely observed for oozing; after the infusion treatment is finished, the tube should be flushed with 20 ml of saline pulse and sealed with positive pressure. If there is a longer period of time without infusion, the tube should be sealed with 20ml saline at least once every 4 weeks. If there are symptoms such as redness, swelling, oozing and pain of the skin and subcutaneous tissue at the infusion port implantation site, the physician should be promptly asked to provide targeted treatment. After the patient’s disease is cured, the infusion port can also be removed through a simple minor surgery.